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Home , Anagrelide, Glycolic acid, Photoaging, Solar urticaria

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PEORIA (309) 674-7546 MORTON (309) 263-7546 GALESBURG (309) 344-5777 PERU (815) 224-7400 NORMAL (309) 268-9980 CLINTON, IA (563) 242-3571 DAVENPORT, IA (563) 344-7546

SoderstromSkinInstitute.comsoderstromskininstitute.com FROMFrom YOUR Your DERMATOLOGISTDermatologist [email protected]@skinnews.com

PHOTOAGING & DAMAGE

Before You Worship The Sun Who’s At Risk? Today, many researchers and dermatologists Skin types that burn easily and tan rarely are believe that wrinkling and aging changes of the skin much more susceptible to the ravages of the sun on the are much more related to sun damage than to age! skin than are those that tan easily, rather than burn. Many of the signs of skin damage from the sun are Light complected, blue-eyed, red-haired people such as pictured on these pages. The decrease in the ozone Swedish, Irish, and English, are usually more suscep- layer, increasing the sun’s intensity, and the increasing tible to photo damage, and their skin shows the signs sun exposure among our population – through work, of photo damage earlier in life and in a more pro- sports, sunbathing and parlors – have taken a nounced manner. Dark complexions give more protec- tremendous toll on our skin. Sun damage to the skin tion from light and the sun. ranks with other serious health dangers of smoking, , and increased cholesterol, and is being seen in younger and younger people.

NO TAN IS A SAFE TAN!

Table of Contents Sun Damage ...... Pg. 1 ...... Pgs. 2-3 Mohs Micrographic Surgery ...... Pg. 4

Prevention & Protection...... Pgs. 5-6 Actual Patient of Soderstrom Skin Institute and Carl Soderstrom, W. MD. Medications ...... Pgs. 7-8 Increased pigment and blotchy discoloration Treatment Options...... Pg. 9-11 secondary to sun damage.

SUN DAMAGE DURING LIFE Younger Older

Roughness Fine Pre Cancer - Mottled Wrinkling Deep Wrinkling Carcinoma Suntan Hyperpigmentation (Lentigines (Sun Spots) (Cancer) Telangiectasia) 16398_01785.qxd:2006_PhotoagingSkinDamage 5/5/09 1:43 PM Page 2 16398_01785.qxd:2006_PhotoagingSkinDamage 5/5/09 1:43 PM Page 3

SKIN CANCER Over 1 million skin cancers are Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD. Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD. found every year in America and 2) Squamous Cell Cancer they are the most common form Squamous cell carcinomas occur at the rate of 208,000 of cancer. Detected early, they per year and can sometimes (albeit infrequently) spread are almost always curable. Actinic Keratoses to the lymph nodes. They make up 16% of skin Precancerous sun spots cancers. Squamous cell cancers frequently develop in frequently seen with sun the sun damaged areas of the skin that have already damage on “midwestern skin.” formed precancerous actinic keratoses. Treatment of these cancers, premalignant areas, and the skin that generates these malignant conditions is advisable. ACTINIC SQUAMOUS CELL KERATOSES CANCER

Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD. 3) Melanoma Cancer More than 50,000 melanomas are discovered each year, which means about 1 in 74 Americans have a lifetime risk of 1) Basal Cell Carcinoma developing melanoma. They make up 4% of all skin can- Basal cell carcinomas are the most cers and if the current rate holds steady, this year one per- common form, and as we might expect, son will die each hour of melanoma. A history of sunburn is most frequently occur on sun exposed areas, significantly associated with individuals with melanomas. particularly the nose, forehead and cheeks. They account for 80% of all skin cancers It is the most serious form of skin cancer and can be found with over 140,000 new cases per year. in sun exposed areas of skin and in non-sun-exposed areas where moles have changed. Melanomas are most commonly found on men’s trunks, and women’s lower legs. BASAL CELL CARCINOMA The most effective treatment for melanoma is early surgical

Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD. Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD. removal, which follows early detection. Our yearly free Solar /Sun Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD. skin cancer Spots screenings have Solar lentigo consists of brown Lentigo Maligna detected many malignant spots, resembling and Begins as a small brown melanomas, as cell damage on sun exposed pigmented spot that slowly well as all areas of the skin. These are extends and darkens in an forms of skin frequently caused by sun irregular fashion. These cancer, on the damage and can be treated with are early melanomas, in citizens of cen- glycolic face treatments, micro- the upper layer of skin. tral Illinois over dermabrasion, chemical peels, the last two or laser resurfacing. SOLAR LENTIGO/ decades. SUN SPOTS LENTIGO MALIGNA MELANOMA CANCER

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Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD. 2) Squamous Cell Cancer Squamous cell carcinomas occur at the rate of 208,000 per year and can sometimes (albeit infrequently) spread to the lymph nodes. They make up 16% of skin cancers. Squamous cell cancers frequently develop in the sun damaged areas of the skin that have already formed precancerous actinic keratoses. Treatment of these cancers, premalignant areas, and the skin that generates these malignant conditions is advisable. SQUAMOUS CELL CANCER 3) Melanoma Cancer More than 50,000 melanomas are discovered each year, which means about 1 in 74 Americans have a lifetime risk of 1) Basal Cell Carcinoma developing melanoma. They make up 4% of all skin can- Basal cell carcinomas are the most cers and if the current rate holds steady, this year one per- common form, and as we might expect, son will die each hour of melanoma. A history of sunburn is most frequently occur on sun exposed areas, significantly associated with individuals with melanomas. particularly the nose, forehead and cheeks. They account for 80% of all skin cancers It is the most serious form of skin cancer and can be found with over 140,000 new cases per year. in sun exposed areas of skin and in non-sun-exposed areas where moles have changed. Melanomas are most commonly found on men’s trunks, and women’s lower legs.

The most effective treatment for melanoma is early surgical

Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD. removal, which follows early detection. Our yearly free Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD. skin cancer screenings have detected many malignant melanomas, as well as all forms of skin cancer, on the citizens of cen- tral Illinois over the last two decades. LENTIGO MALIGNA MELANOMA CANCER

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Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD. MOHS MICROGRAPHIC SURGERY Mild & Severe Rhytides/ Wrinkles Mohs surgery is a highly specialized treatment and pleasant. They are completely Medicare approved Mild and severe wrinkling of the upper layer for the total removal of skin cancer. This method and accredited by the Accreditation Association for of the dermis caused by sun damage. differs from all other methods of treating skin cancer Ambulatory Health Care, Inc. by the use of complete microscopic examination of all the tissues removed surgically, as well as detailed MILD RHYTIDS MODERATE RHYTIDS mapping techniques to allow the surgeon to remove all the roots and extensions of the skin cancer. TIPS...... FOR PROTECTING OURSELVES FROM SUN’S DAMAGING The procedure, performed here at Soderstrom RAYS INCLUDE: Skin Institute by a Mohs micrographic surgeon, is SUN DAMAGE AVOIDANCE & begun after the skin is injected with a local anesthetic 1. Avoiding the hot sun from 10:00am to to make it completely numb. Then the visible cancer 4:00pm. PROTECTION SAVES LIVES and a very thin layer of skin are removed with a scalpel, Sun in Moderation The prevention of damage to the skin from carefully mapped, and examined microscopically. If 2. Wearing a wide-brimmed hat. Treatment for all of the different ramifications exposure to the sun’s (UV) rays consists cancer is still present under the microscope, another of sun damage includes a stepwise approach, designed largely of protection. There are several ways to protect very thick layer of skin is removed from that exact 3. Wearing long-sleeved light weight the skin from this damage. location. This may be repeated to completely remove shirts and blouses. in a thoughtful manner specifically for each individual the cancer, and these are are called stages. patient. First, and most obviously, it is important to 4. Wearing all year long. avoid further exposure to the sun and UVA and UVB 1. AVOIDANCE: Avoid activities in the sun from rays. This can be done by following the prevention 10:00am to 4:00pm. These are the hours of the Advantages in Mohs Surgery 5. Avoiding reflective surfaces such as guidelines below: day when the sun’s rays are the most direct and By using the detailed mapping techniques and and snow. potentially the most damaging to the skin. complete microscopic control, the Mohs surgeon can Sun Avoidance and Protection Saves Lives! pinpoint areas involved with cancer that are otherwise 6. Minimizing sun exposure. The sun emits two types of rays that cause 2. CLOTHING: Protect exposed areas with wide invisible to the naked eye. Therefore, even the smallest damage to the skin, ultraviolet A (UVA) and ultraviolet 7. Avoiding tanning parlors. brimmed hats and lightweight, long-sleeved shirts microscopic root of cancer can be removed. The result B (UVB). UVB rays are commonly called burning rays, and blouses. A loose fitting tightly woven fabric is is: 1) the removal of as little normal skin as possible, affecting the top layer of skin, causing pain, redness, best because the loose fit allows for a cooling effect and 2) the highest potential of curing the cancer. and swelling. UVA rays penetrate deeper to the second while the tight weave prevents penetration of the layer of skin and are often called “tanning rays.” sun’s rays. Light colored fabrics reflect the sun away These UVA rays stimulate the production of pigment Cure Rate Disclaimer from the body. Gloves may be appropriate for out- to protect the skin from the damaging effects of the Mohs surgery is the most accurate method for Any form of treatment will leave a scar. door work. removing skin cancers. In previously treated cancers, However, because Mohs surgery removes as little radiation. Therefore, there is no such thing as a where other forms of treatment offer only 80%-90% normal tissue as possible, scarring is minimized. “healthy” tan. In addition, UVA rays cause permanent 3. LOCATION: Remember that reflective surfaces, chance of success, Mohs surgery is 95% effective. Immediately after the cancer is removed, we may damage to the underlying support structure of the choose 1) to allow the wound to heal by itself, 2) to skin which results in premature wrinkling and aging such as water, and even snow, intensify the sun’s repair the wound with stitches, or a skin graft or flap, effects. Over time, the radiation can cause changes at damaging effects. The Earth’s atmosphere filters UV Peoria Ambulatory Surgery Center or 3) to send the patient to the referring physician or the cellular level which can result in the development rays, as smog, dirt, and pollution. Sun damage will Mohs surgery is performed in our pleasant another surgeon for wound repair. The decision is of skin cancers and other nonmalignant skin lesions. occur more readily on a beach by the water than on outpatient surgery center - Peoria Ambulatory Surgery based on the safest method that will provide the best Even though a tan disappears in the winter, the sun a city rooftop. Sitting in the shade offers protection Center. There are many advantages to this same cosmetic results. damage does not. It is permanent and cumulative. from less than half of the sun’s rays. High altitudes day surgery center but the key points include cost In other words, damage continues to add up year allow a concentrated dose of UV radiation, even in effectiveness and privacy. The staff at Peoria after year after year. the winter. Remember, it is the sun’s rays, not the Ambulatory Surgery Center strive to make every temperature that is dangerous. surgical experience thorough, effective, efficient,

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Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD.

Mild & Severe Rhytides/ Wrinkles Mild and severe wrinkling of the upper layer of the dermis caused by sun damage.

MILD RHYTIDS MODERATE RHYTIDS

SUN DAMAGE AVOIDANCE & PROTECTION SAVES LIVES Sun in Moderation The prevention of damage to the skin from Treatment for all of the different ramifications exposure to the sun’s ultraviolet (UV) rays consists of sun damage includes a stepwise approach, designed largely of protection. There are several ways to protect in a thoughtful manner specifically for each individual the skin from this damage. patient. First, and most obviously, it is important to avoid further exposure to the sun and UVA and UVB 1. AVOIDANCE: Avoid activities in the sun from rays. This can be done by following the prevention 10:00am to 4:00pm. These are the hours of the guidelines below: day when the sun’s rays are the most direct and potentially the most damaging to the skin. Sun Avoidance and Protection Saves Lives! The sun emits two types of rays that cause 2. CLOTHING: Protect exposed areas with wide damage to the skin, ultraviolet A (UVA) and ultraviolet brimmed hats and lightweight, long-sleeved shirts B (UVB). UVB rays are commonly called burning rays, and blouses. A loose fitting tightly woven fabric is affecting the top layer of skin, causing pain, redness, best because the loose fit allows for a cooling effect and swelling. UVA rays penetrate deeper to the second while the tight weave prevents penetration of the layer of skin and are often called “tanning rays.” sun’s rays. Light colored fabrics reflect the sun away These UVA rays stimulate the production of pigment from the body. Gloves may be appropriate for out- to protect the skin from the damaging effects of the door work. radiation. Therefore, there is no such thing as a “healthy” tan. In addition, UVA rays cause permanent damage to the underlying support structure of the 3. LOCATION: Remember that reflective surfaces, skin which results in premature wrinkling and aging such as water, and even snow, intensify the sun’s effects. Over time, the radiation can cause changes at damaging effects. The Earth’s atmosphere filters UV the cellular level which can result in the development rays, as smog, dirt, and pollution. Sun damage will of skin cancers and other nonmalignant skin lesions. occur more readily on a beach by the water than on Even though a tan disappears in the winter, the sun a city rooftop. Sitting in the shade offers protection damage does not. It is permanent and cumulative. from less than half of the sun’s rays. High altitudes In other words, damage continues to add up year allow a concentrated dose of UV radiation, even in after year after year. the winter. Remember, it is the sun’s rays, not the temperature that is dangerous.

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4. MEDICATIONS: Photosensitivity, an Since tanning represents the body’s response to adverse reaction to , characterized by injury, chronic exposure to ultraviolet rays, rash, redness and/or swelling, can be a side whether it be from the sun or tanning units, effect of certain medications. causes the skin to become coarse, wrinkled, and leathery in appearance. 5. DISEASES: Some diseases can be either initiated or made worse by UVB and UVA The UV light of a tanning booth also increases exposure. These include polymorphous light the risk of skin cancer. Understanding the eruption (PMLE), chronic actinic dermatitis, consequences of exposure to both indoor and actinic reticuloid, , and outdoor sources of radiation is a first step in the (). process of changing tanning practices, thereby reducing the risk of developing skin cancers. 6. SUNSCREENS: Sunscreens are a vital protection for everyone, even people who tan The Skin Cancer Foundation has declared that it easily. These products are as necessary on the is “...abundantly clear that these devices lead to ski slope as they are on a tropical beach. an increase in visible damage to the skin and Sunscreens: Sunscreens are rated by a standardized Sun skin cancer.” (“Dark Duplicity: False Claims Further study into the effects of ultraviolet Protection Factor (SPF) based on the ability of for Sunlamps Start Again”, Sun & Skin News, Remember, the lips are also exposed radiation on the skin demonstrated the damaging the product to prevent sun damage. Any sun A Publication of the Skin Cancer Foundation) to damage from the sun’s rays. Look for lip effects of UVA radiation. This has lead to a new screen requires reapplication when perspiring, protection that contains with an SPF15 generation of broad spectrum sunscreens that 8. SELF TANNING LOTIONS: after swimming, or when the effectiveness has or better such as Vanicream™ Lip Protectant protect the skin from other UVB and UVA If it’s a nice golden tan you are after you may “worn off.” There are waterproof sunscreens SPF30, available at Soderstrom Skin Institute. radiation. It is important to check the product want to consider some of the self-tanning available, but the directions listed on the label label to determine not only how much protection should be carefully followed. Remember to lotions that are available on the market today. What is an SPF? the sunscreen provides (SPF), but also what kind apply sunscreens to extra susceptible areas like These products contain an active ingredient of protection (against UVB rays or both UVB and the ears, lips, and nose. Be cautious even on known as dihydroxyacetone (DHA), a colorless UVA rays). There are many sunscreens available SPF stands for Sun Protection Factor and cloudy, hazy days, as 70% to 80% of the sun’s sugar that darkens the skin by staining. DHA on the market today. See picture above for a is a standardized measurement of the ability of damaging rays can penetrate cloud cover or works by interacting with the dead surface cells variety of products available at Soderstrom Skin a product to prevent sun damage by absorbing water. found in the , or the outermost layer Institute. of the skin, producing a color change. As the radiation. During the initial testing of these products it was determined that, on the average, dead skin cells are naturally sloughed off, the 7. TANNING BOOTHS AND PARLORS: it takes ten minutes of sun exposure to produce a color gradually fades - typically within five to %UVB Tanning parlors claim to offer all the good sunburn. Ideally, the SPF number tells how many seven days of a single application. Skin SPF Absorption* looks of a tan with none of the risks. This times more than ten minutes an individual can Dimensions Day Spa offers self tanning simply is not true. Both outdoor and indoor stay in the sun before a burn will occur. 8 87.5% sources of UV light produce detrimental lotion as well as a spray tanning technique. Therefore, a product with an SPF of 8 would 10 90.0% changes in the skin. In fact, the bulbs used in protect the wearer from a sunburn for eighty 15 93.3% tanning beds emit two to three times the amount minutes, a factor of 15 would offer a little over 20 95.0% of UVA rays that are normally received from two hours protection and so on. Keep in mind 25 96.0% the sun. It has been shown that an individual that ten minutes is only an average. Everyone’s 29 96.6% who spends 30 minutes in a tanning bed is tolerance to sunlight will be somewhat different. 39 97.4% receiving the amount of sun damage equivalent Environmental conditions such as being in and out of water, to perspiration will decrease the to spending an entire day laying out in the *Calculated using the reciprocal of SPF from the sun at the beach. amount of protection offered regardless of the method of Sayre RM et al. A comparison of in vivo and in vitro testing of sunscreen formulas. SPF. For maximum protection, the best rule is to Photochemistry and Photobiology 1979; 29: 559-566. reapply any sunscreen approximately every two hours.

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Sunscreens: Further study into the effects of ultraviolet Remember, the lips are also exposed radiation on the skin demonstrated the damaging to damage from the sun’s rays. Look for lip effects of UVA radiation. This has lead to a new protection that contains sunscreen with an SPF15 generation of broad spectrum sunscreens that or better such as Vanicream™ Lip Protectant protect the skin from other UVB and UVA SPF30, available at Soderstrom Skin Institute. radiation. It is important to check the product label to determine not only how much protection What is an SPF? the sunscreen provides (SPF), but also what kind of protection (against UVB rays or both UVB and UVA rays). There are many sunscreens available SPF stands for Sun Protection Factor and on the market today. See picture above for a is a standardized measurement of the ability of variety of products available at Soderstrom Skin a product to prevent sun damage by absorbing Institute. radiation. During the initial testing of these products it was determined that, on the average, it takes ten minutes of sun exposure to produce a %UVB sunburn. Ideally, the SPF number tells how many SPF Absorption* times more than ten minutes an individual can stay in the sun before a burn will occur. 8 87.5% Therefore, a product with an SPF of 8 would 10 90.0% protect the wearer from a sunburn for eighty 15 93.3% minutes, a factor of 15 would offer a little over 20 95.0% two hours protection and so on. Keep in mind 25 96.0% that ten minutes is only an average. Everyone’s 29 96.6% tolerance to sunlight will be somewhat different. 39 97.4% Environmental conditions such as being in and out of water, to perspiration will decrease the *Calculated using the reciprocal of SPF from the amount of protection offered regardless of the method of Sayre RM et al. A comparison of in vivo and in vitro testing of sunscreen formulas. SPF. For maximum protection, the best rule is to Photochemistry and Photobiology 1979; 29: 559-566. reapply any sunscreen approximately every two hours.

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Awareness Of Medications Haloperidol Olanzapine Henna Oral contraceptives St John's wort Reacting To Sun Herion Oxaprozin Streptomycin There are certain medication that can Hydralazine Oxcarbazepine TREATMENTS make our skin more sensitive to the sun. These Hydrochlorothiazide Oxytetracycline Sulfadiazine Hydroflumethiazide Sulfadoxine may increase sun damage and should be avoided Hydroxychloroquin Pantoprazole Sulfamethoxazole Your physician will design a program for if you do not wear a sunscreen or if you are Hydroxyurea Paroxetine Sulfasalazine your skin involving some or all of the below going to be outdoors a lot. Hydroxyzine Pentobarbital Sulfisoxazole The newest form of treatment is photodynamic treatment programs. Diligent adherence Hyoscyamine Pentosan Sulindac therapy using a topical chemical and blue light. The Acetaminophen Citalopram Sumatriptan to the programs can result in partial rever- Acetazolamide Clemastine Imipramine Perphenazine Tacrolimus chemical hydrochloride (ALA) is sal of many of the changes Acetohexamide Clofazimine Indapamide Phenelzine Tartrazine applied topically to areas to be treated and left in Acitretin Clofibrate (Atromid-S) Indomethacin Phenindamine Terbinafine that occur on human sun exposed skin. Acyclovir Clomipramine Infliximab Phenobarbital place for 24 hours. Chemical reactions with the skin Aldesleukin Clorazepate Interferon beta 1-a Pimozide Thioguanine produce the photosensitizing chemical protoporphyrin Clozapine Interferons, alfa-2 Piroxicam Thioridazine TREAT CANCERS EARLY IX. When protoporphyrin IX is exposed to blue light Allopurinol Co-trimoxazole Isocarboxazid Polythiazide Thiothixene Almotriptan Cromolyn Isoniazid Pravastatin Tiagabine The treatment of skin cancers includes: by a special illuminating device it causes death of Alprazolam Cyclamate Timolol AK cells. Retreatment may be necessary if new AKs Amantadine Cyclobenzaprine Itraconazole Prochlorperazine Tiopronin 1. Freezing them off with cryosurgery. Amiloride Cyclothiazide Kanamycin Procyclidine Tolazamide appear months to years later. Aminolevulinic acid Cyproheptadine Kava Promazine Tolbutamide 2. Excision of the lesions with deep skin shaving Aminosalicylate sodium Ketoconazole Promethazine Topiramate Chemical Peels Aminodarone Danazol Ketoprofen Propranolol Torsemide or excising. Amitriptyline Dantrolene Ketotifen Propylthiouracil Tranylcypromine A Chemical Peel is a noninvasive technique Amobarbital Lamotrigine Protriptyline Trazodone for restoring wrinkled, blemished, unevenly pigmented, Amoxapine Demeclocycline 3. Destruction of the lesion by electric current Leuprolide Psoralens or sun damaged facial skin, using a chemical solution Anagrelide Desipramine Levofloxacin Pyridoxine Triamterene and curetting them off. Anthrax vaccine Dexchlorpheniramine Lincomycin Pyrilamine Triazolam to peel away the skin’s top layers. The new cells that Arsenic Diazoxide Lisinopril Pyrimethamine Trichlormethiazide form during the healing process produce a smoother, Atenolol Diclofenac 4. Laser surgery with excision of the tumor by Lomefloxacin Quetiapine Trifluoperazine tighter, younger looking skin surface. Atorvastatin Diflunisal Loratadine Quinacrine Trihexyphenidyl laser light. Atropine sulfate Diltiazem Losartan Quinapril Trimeprazine Azatadine Dimenhydrinate Loxapine Quinestrol Trimethadione There are three types of Chemical Peels used at Azathioprine Maprotiline Quinethazone Trimethoprim 5. Plastic Surgery - Surgical excision with suturing. Azithromycin Disopyramide Meclizine Quinidine Trimetrexate Soderstrom Skin Institute and Skin Dimensions Day Spa. Benazepril Meclofenamate Quinine Trimipramine 6. Mohs micrographic surgery for larger and recu- Bendroflumethiazide Doxepin Medroxyprogesterone Rabeprazole Trioxsalen Glycolic: Alpha-Hydroxy Acids Benzthiazide Mefenamic acid Ramipril Tripelennamine rrent tumors requires chemical tracking of can Benztropine Efavirenz Melatonin Ranitidine Triprolidine cer roots for complete removal. AHA’s are a group of nontoxic, organic Betaxolol Enalapril Meloxicam Ribavirin Trovafloxacin substances found naturally in many common fruits Enoxacin Meprobamate Riluzole Valdecoxib Bisoprolol Risperidone Valproic acid 7. Radiation therapy for certain types or locations, and foods. Acid from apples, tartic acid from grapes, Brompheniramine Epoetin alfa Mesalamine Ritonavir Valsartan such as on the eyelids or in debilitated patients citric acid from citrus fruits, and from sour Bumetanide Estazolam Mesoridazine Rofecoxib Venlafaxine milk are all examples of AHA’s. Glycolic acid, the Bupropion Metformin Ropinirole Verapamil unable to undergo surgery. Butabarbital Ethacrynic acid Methazolamide Saccharin simplest of all the hydroxy acids, has the greatest Butalbital Ethambutol Methenamine Saquinavir penetration potential due to its small molecular size. Ethionamide Scopolamine Vitamin A As a result, glycolic acid is said to provide the greatest Captopril Etodolac Methoxsalen Selegiline Voriconazole Cryosurgery Carbamazepine Felbamate Methyclothiazide Sertraline Zalcitabine Cryosurgery using liquid nitrogen is a benefits for skin care in comparison to other commonly Carisoprodol Fenofibrate Methyldopa Zaleplon used AHA’s. The estheticians at Skin Dimensions Carteolol Flucytosine very effective method to treat and remove the Methylphenidate Simvastatin Ziprasidone Day Spa and the dermatology nursing staff perform Carvedilol Metolazone Smallpox vaccine Zolmitriptan precancerous sun spots such as actinic keratoses. Cefazolin Fluoxetine Solalol Zolpidem This chemical, at 207 degrees below zero, peels off glycolic peels that come in three different strengths Ceftazidime Fluphenazine Minoxidil Sparfloxacin ranging from 40%-99%. The glycolic peel smoothes Flurbiprofen Mirtazapine the damaged layer of skin only in the spots where Cetirizine Mitomycin Others liquid nitrogen is applied, and new skin develops in and hydrates roughened, sun damaged skin, helps Cevimeline Fluvastatin Moexipril Bergamot oil*, oils of citron, lavendar, lime, those areas. diminish and acne scarring, cleanses facial pores Fluvoxamine Molindone sandalwood, and cedar. (Used is perfumes and and helps reduce fine lines and wrinkles. Glycolic Chlordiazepoxide Fosinopril Moxifloxacin .) Also topical exposure to citrus rind oils. Chlorhexidine Furazolidone Nabumetone Benzocaine 5-Fluorouacil face treatments are available at Skin Dimensions Chloroquine Furosemide Nalidixic acid Etretinate (Tegison) 5-Fluorouacil is an anticancer drug that is Day Spa. Call (309) 691-9381 for an appointment. Chlorothiazide Ganciclovir Naproxen Goldsalts (Myochrysine and Solganal) Chlorotrianisene Gatfloxacin Naratriptan Lovasatin (Mevacor) used in a cream form. This medication seeks out Chlorpheniramine Gentamicin Nefazodone 6-methylcoumarin (Used in perfumes, shaving lotions, cancerous or precancerous cells, irritates them on the Chlorpromazine Glimepiride Nifedipine and sunscreens.) Chlorpropamide Glipizide Nisoldipine Musk ambrette (Used in perfumes.) skin and causes them to peel off. This is a very Chlortetracycline Glyburide Nitrofurantoin effective form of mild to limited peeling of the skin, Chlorthalidone Glycopyrrolate Norfloxacin *Reactions occur frequently. oftentimes leaving new and rejuvenated skin in the Cinoxacin Gold and gold compounds Nortriptyline Note: No sunscreen can guarantee protection from a Ciprofloxacin Griseofulvin Ofloxacin photosensitivity reaction when using any of these drugs. area of the peeling.

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TREATMENTS

Your physician will design a program for Photodynamic Therapy your skin involving some or all of the below The newest form of treatment is photodynamic treatment programs. Diligent adherence therapy using a topical chemical and blue light. The to the programs can result in partial rever- chemical aminolevulinic acid hydrochloride (ALA) is sal of many of the photoaging changes applied topically to areas to be treated and left in that occur on human sun exposed skin. place for 24 hours. Chemical reactions with the skin produce the photosensitizing chemical protoporphyrin TREAT CANCERS EARLY IX. When protoporphyrin IX is exposed to blue light The treatment of skin cancers includes: by a special illuminating device it causes death of AK cells. Retreatment may be necessary if new AKs 1. Freezing them off with cryosurgery. appear months to years later.

2. Excision of the lesions with deep skin shaving Chemical Peels or excising. A Chemical Peel is a noninvasive technique for restoring wrinkled, blemished, unevenly pigmented, 3. Destruction of the lesion by electric current or sun damaged facial skin, using a chemical solution and curetting them off. to peel away the skin’s top layers. The new cells that form during the healing process produce a smoother, 4. Laser surgery with excision of the tumor by laser light. tighter, younger looking skin surface.

5. Plastic Surgery - Surgical excision with suturing. There are three types of Chemical Peels used at Soderstrom Skin Institute and Skin Dimensions Day Spa. 6. Mohs micrographic surgery for larger and recu- Glycolic: Alpha-Hydroxy Acids rrent tumors requires chemical tracking of can cer roots for complete removal. AHA’s are a group of nontoxic, organic substances found naturally in many common fruits 7. Radiation therapy for certain types or locations, and foods. Acid from apples, tartic acid from grapes, such as on the eyelids or in debilitated patients citric acid from citrus fruits, and lactic acid from sour unable to undergo surgery. milk are all examples of AHA’s. Glycolic acid, the simplest of all the hydroxy acids, has the greatest penetration potential due to its small molecular size. Cryosurgery As a result, glycolic acid is said to provide the greatest Cryosurgery using liquid nitrogen is a benefits for skin care in comparison to other commonly very effective method to treat and remove the used AHA’s. The estheticians at Skin Dimensions precancerous sun spots such as actinic keratoses. Day Spa and the dermatology nursing staff perform This chemical, at 207 degrees below zero, peels off glycolic peels that come in three different strengths the damaged layer of skin only in the spots where ranging from 40%-99%. The glycolic peel smoothes liquid nitrogen is applied, and new skin develops in and hydrates roughened, sun damaged skin, helps those areas. diminish acne and acne scarring, cleanses facial pores and helps reduce fine lines and wrinkles. Glycolic 5-Fluorouacil face treatments are available at Skin Dimensions 5-Fluorouacil is an anticancer drug that is Day Spa. Call (309) 691-9381 for an appointment. used in a cream form. This medication seeks out cancerous or precancerous cells, irritates them on the skin and causes them to peel off. This is a very effective form of mild to limited peeling of the skin, oftentimes leaving new and rejuvenated skin in the area of the peeling.

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TCA Peels Trichloroacetic acid has been used to perform skin peels for over 30 years. Unlike some other types of peels, TCA peels have the additional advantage of Retinol (Retin-A) creating a fresh natural appearing complexion, while Retin-A, or tretinoin, is a drug that was first Microdermabrasion preserving the normal skin color. TCA peels can discovered because of its help in treating blackhead Microdermabrasion is a process that effectively improve many conditions, including: acne. It causes many changes in the skin, however, utilizes miniscule grains of aluminum oxide Dull, weathered skin several of which have to do with the partial reversal Freckling of sun damaged areas. It comes in several crystals to gently exfoliate the skin while Blotchy pigmentation strengths, and is applied once or more daily until restoring smoothness and softness. With (including the mask of pregnancy) results are obtained. Many of the photoaging microdermabrasion, the outer layer of the Sun Damage changes, including wrinkling, pigment spots and (including some precancerous lesion) precancers, can be lessened with the use of Retin-A. skin is thinned gradually during five to Fine wrinkles eight sessions conducted at intervals of Shallow acne scars seven to ten days. The whole process takes TCA peels are performed by our physicians. A just minutes! solution containing TCA is applied to your skin. This is usually associated with 2-3 minutes of a burning and Call (888) 970-SKIN for an appointment. stinging sensation. This burning is so brief that most patients choose not to use any sedation or anesthesia.

When TCA is applied to the skin, it causes the Laser Beam top layers of cells to dry up and peel off over a period of several days. When the old skin has peeled off, it Laser therapy has become a very exposes a new layer of undamaged skin, which has a exciting technology advancement for smoother texture and more even color. dermatology as it is extremely effective in TCA peels can be performed on most skin types reversing the wrinkles and age spots resulting but not everyone is a candidate as with any procedure. from sun damage. Treatment involves using BEFORE Actual patient of Carl W. Soderstrom, M.D. Unlike AHA peels, excellent results can usually be the Ultrapulse CO2 and/or the Erbium Laser obtained with one peel; although a second TCA peel may be necessary for some skin problems. which transmits pulse of colorless, light into one layer of skin at a time. This Phenol Acid Peels allows the surgeon to tighten and resurface Phenol is the strongest of the chemical solutions and produces a deep peel. It is used mainly to treat the skin one layer at a time. patients with coarse facial wrinkles, areas of blotchy or damaged skin caused by sun exposure, or precancerous growths. Phenol peels are performed in our Peoria Ambulatory Surgery Center by one of our board certified Plastic Surgeons.

All treatments require an initial consultation. For an appointment, please call (888) 970-SKIN or visit our website at SoderstromSkinInstitute.com. AFER USING Actual patient of Carl W. Soderstrom, M.D. RETIN-A

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Retinol (Retin-A) Retin-A, or tretinoin, is a drug that was first Microdermabrasion discovered because of its help in treating blackhead Microdermabrasion is a process that acne. It causes many changes in the skin, however, utilizes miniscule grains of aluminum oxide several of which have to do with the partial reversal of sun damaged areas. It comes in several crystals to gently exfoliate the skin while strengths, and is applied once or more daily until restoring smoothness and softness. With results are obtained. Many of the photoaging microdermabrasion, the outer layer of the changes, including wrinkling, pigment spots and precancers, can be lessened with the use of Retin-A. skin is thinned gradually during five to eight sessions conducted at intervals of seven to ten days. The whole process takes just minutes!

Call (888) 970-SKIN for an appointment.

Laser Beam Laser therapy has become a very exciting technology advancement for dermatology as it is extremely effective in reversing the wrinkles and age spots resulting from sun damage. Treatment involves using BEFORE Actual patient of Carl W. Soderstrom, M.D. the Ultrapulse CO2 and/or the Erbium Laser which transmits pulse of colorless, infrared light into one layer of skin at a time. This allows the surgeon to tighten and resurface the skin one layer at a time.

AFER USING Actual patient of Carl W. Soderstrom, M.D. RETIN-A

11 SODERSTROM SKIN INSTITUTE LOCATIONS

ILLINOIS

PEORIA • 4909 N. Glen Park Place • 309.674.7546 MORTON • 410 Maxine Drive • 309.263.7546 NORMAL • 2100 Jacobssen Drive • 309.268.9980 PERU • 2200 Marquette Road • 815.224.7400 GALESBURG • 60 S. Soangetaha Road • 309.344.5777 MOLINE • 1302 7th Street • 309.277.0772

IOWA

DAVENPORT • 1800 East 54th Street • 563.344.7546 CLINTON • 2315 Roosevelt Street • 563.242.3571 MUSCATINE • 2300A Park Ave • 563.263.2113

TO VIEW ADDITIONAL LOCATION INFORMATION, VISIT SODERSTROMSKININSTITUTE.COM/LOCATIONS